AzTrials
AzTrials

Patello Femoral Pain SyndromeNCT07854041

Active Release and Myofascial Release Technique in Patients With Patellofemoral Pain Syndrome

A study testing Group A and Group B in people with Patello Femoral Pain Syndrome, run by Riphah International University at 1 site in Pakistan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Patellofemoral pain syndrome (PFPS) is often associated with imbalance and weakness in several key muscle group. These include the quadriceps (especially the vastus medialis oblique), hip abductors and external rotators and hamstrings as well as tightness in iliotibial band and gastrocnemius. Read more about this study

Who is it for?
Ages 15 to 40 years
Conditions the study is for
Patello Femoral Pain Syndrome
What is being tested?
Group A and Group B
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 sitePakistan
Study dates
1 Jun 2026to 1 Jan 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 40 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Experience retro patellar pain for at least three months, including pain at rest or during activities such as ascending or descending stairs, jumping, running, squatting, kneeling, or prolonged sitting (12).
  • Patients with + ive Squat test in the absence of any pathology
  • Patients also must have presented with an insidious onset of symptoms unrelated to trauma and a positive Clark test (19).
  • Reduced knee range of motion, especially extension

Who cannot join

  • A history of significant lower extremity, pelvic, or spinal surgery/fracture, or traumatic lesions of ligaments or meniscus within the past six months.
  • Presence of other orthopedic conditions (e.g., ACL rupture, meniscal tears), neurological disorders (e.g., multiple sclerosis, paralysis), rheumatological diseases (e.g., rheumatoid arthritis, ankylosing spondylitis), or congenital conditions leading to osteoarthrosis.
  • Current pregnancy
  • A history of connective tissue disease, patellofemoral dislocation or subluxation, osteoarthrosis of the knees.
  • Other forms of anterior knee pain (e.g., Osgood-Schlatter disease, tendon pain, bursitis). A history of referred pain from the lumbar spine (12). or

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Syed Shakil ur Rehman, PhD contact

+92 320 786661

shakil.urrehman@riphah.edu.pk

Pakistan1 site, 1 recruiting
  • Riphah Rehabilitation Clinic

    Lahore, Punjab Province, 54000

    Syed Shakil ur Rehman, PhD, +92 320 7866611, shakil.urrehman@riphah.edu.pk

    Recruiting

Other trials in Pakistan

About this study

Official title: Comparison of Active Release and Myofascial Release Technique on Pain, Range of Motion and Function in Patients With Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is often associated with imbalance and weakness in several key muscle group. These include the quadriceps (especially the vastus medialis oblique), hip abductors and external rotators and hamstrings as well as tightness in iliotibial band and gastrocnemius. Exercises involving isometrics, stretching, strengthening of knee along with core muscles has improved range, strength, coordination and motor control. This study aim to determine the effects of active release along with myofascial release technique on pain, range of motion and function in patients with patellofemoral pain syndrome.

This study will be a randomized controlled trial and will be conducted in Riphah Rehabilitation Clinic Lahore (Physiotherapy Department) and Ghurki Trust Hospital Lahore. Non-probability consecutive sampling will be used to collect the data. Sample size of 30 subjects with age group between 15-40 years will be taken. Data will be collected from the patients having present complaint of anterior knee pain. Outcome measures will be taken by using Numeric pain rating scale (NPRS), Anterior knee pain scale (AKPS)for pain, Universal Goniometer (GU) for Range of motion and KOOS PS scale to assess physical function in patient with knee pain. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive RICE protocol, ice, stretching, strengthening and knee isometrics exercises, while Group A will receive active release and Group B will receive myofascial release technique. Outcome measures will be measured at baseline and after 6 weeks. Data analysis will be done by SPSS version 25.

Read the detailed description

Patellofemoral pain syndrome (PFPS) is a prevalent source of knee pain among adolescents and young adults. It is defined as pain occurring in the prepatellar or retropatellar region that worsens during prolonged sitting, kneeling, squatting, and stair climbing. Patellofemoral pain syndrome (PFPS) is a musculoskeletal disorder characterized by anterior knee pain, typically resulting from increased stress on the patellofemoral joint. Patellofemoral pain syndrome (PFPS) is a broad term that covers various conditions affecting the patellofemoral joint (PFJ), including extensor mechanism dysfunction, patellar subluxation, and runner's knee. PFPS is usually characterized by physical and biomechanical changes within the joint, which may involve altered patellar tracking, muscle imbalances, and soft tissue restrictions, such as weakness in the quadriceps or tightness in the hamstring muscles, all contributing to joint dysfunction and pain.

The prevalence of PFPS in adolescents is between 20 and 40%, with around 1 in 10 male recruits experiencing the condition. A study on a mixed-gender recruitment population found that the prevalence of the condition in females was about 2.23 times higher than in males. The annual prevalence rate for the general adult population was reported to be 22.7%, with rates of 29.2% for women and 15.5% for men. The aetiology of PFPS is unknown, although muscle imbalance, tendonitis, or insertional tendinosis of the extensor apparatus, patellar instability, and chondral and osteochondral damage can be involved in the pathogenesis of the disease. A combination of factors, such as abnormal lower limb biomechanics, soft-tissue tightness, muscle weakness, and excessive exercise may result in increased cartilage and subchondral bone stress and subsequent PFPS.

There is clear consensus that the etiology of patellofemoral pain syndrome (PFPS) is multifactorial in nature. Several risk factors have been proposed as possible parameters involved in pathogenesis of PFPS. These risk factors are classified as intrinsic or extrinsic risk factors. Extrinsic risk factors are related to factors outside human body, such as the type of sports activity, environmental conditions, and the surface and equipment used. Intrinsic risk factors relate more to individual characteristics. The review of existing literature has shown that some modifiable risk factors have been theorized to play a role in the development and persistence of PFPS, including quadriceps weakness, specifically in vastus medialis oblique (VMO) , tightness of hamstring , tightness of iliopsoas , tightness of iliotibial band , tightness of gastrosoleous , hip muscles dysfunction, especially abductors and external rotators , foot over pronation , generalized joint laxity , limb length discrepancy , patellar malalignment and patellar hypermobility.

Active Release Techniques (ART) is a noninvasive, soft tissue treatment process that both locates and breaks down the scar tissue and adhesions which cause pain, stiffness, weakness, numbness, and physical dysfunctions associated with Repetitive Strain Injuries. ART is used both for the treatment of RSI injuries, as well as for the improvement of athletic performance. ART aims to return complete translation or relative motion to the full length of the affected soft tissue and to its adjacent soft-tissue structures. Active release techniques (ART) is classified as a multidisciplinary procedure that is practiced by numerous practitioners from a wide range of medical professions and disciplines, including Chiropractors, Physiotherapists, Massage Therapists, Kinesiologists, Occupational Therapists, and Sports physicians. The goals of ART are to restore optimal tissue texture, tension and movement, restore the strength, flexibility, function, and relative translation between soft tissue layers, release any soft tissue restrictions, entrapped nerve, restricted circulatory structures, or lymphatic restrictions. ART is used to normal texture, tension, and length by using various hand positions and soft tissue manipulation methods.

MFR techniques focus on relieving tension and restoring flexibility in the fascia and muscles surrounding the knee joint. This technique can be performed through palpation of tight muscle areas, use of compressive techniques to mobilize muscle tissue, and use of dynamic movements to release fascial restrictions. The release is maintained until relaxation is perceived, ensuring the tissue is restored to its natural state.

Being tested
Group A, Group B
Keywords
Active release technique, Anterior knee pain, Range of motion, myofascial release, Patello Femoral pain Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Group AOther

    Before applying active release technique, assess the knee joint, by palpating the area of tightness, tenderness and restricted movement .Then apply specific pressure to affected tissues, such as the quadriceps, hamstrings, iliotibial band (IT band) or patellar tendon, depending on the findings of the evaluation. The patient will then actively move the knee joint through prescribed range of motions, while the therapist maintain contact and provides appropriate pressure. This process is repeated several times, with the therapist adjusting pressure and movements as needed to improve tissue mobility and reduce pain.

  • Group BOther

    For Myofascial release technique therapist will use their hands to apply sustained pressure to restricted areas fascia, gradually lengthening and releasing the tissue. Gentle stretching techniques can also be used to lengthen the tissue and muscles, improving flexibility and range of motion.

Study groups in NCT07854041
Study groupRoleWhat they receive
Active release techniqueExperimentalBefore applying active release technique, assess the knee joint, by palpating the area of tightness, tenderness and restricted movement .Then apply specific pressure to affected tissues, such as the quadriceps, hamstrings, iliotibial band (IT band) or patellar tendon, depending on the findings of the evaluation. The patient will then actively move the knee joint through prescribed range of motions, while the therapist maintain contact and provides appropriate pressure. This process is repeated several times, with the therapist adjusting pressure and movements as needed to improve tissue mobility and reduce pain.
Receives: Other: Group A
Myofascial Release TechniqueActive comparatorFor Myofascial release technique therapist will use their hands to apply sustained pressure to restricted areas fascia, gradually lengthening and releasing the tissue. Gentle stretching techniques can also be used to lengthen the tissue and muscles, improving flexibility and range of motion.
Receives: Other: Group B

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Lower Extremity Functional Scale

    The lower extremity functional scale (LEFS) is a valid patient-rated outcome measure (PROM) for the measurement of lower extremity function. The scale consist of 4 groups with 20 questions.

    The questions in these group focus on activities with increasing physical demands like questions from walking between rooms to running on uneven ground. The scoring of this scale varies from 0 (extreme difficulty/unable to perform activity) to 4 (no difficulty). The total score can be obtained by summing the scores of the individual items. The maximum score of 80 indicates no functional limitations and the minimum score of 0 indicates extreme limitations

    Measured: Baseline; 6 Weeks

  2. Patellofemoral Pain and Osteoarthritis Subscale of Knee injury and Osteoarthritis Outcome Score

    Patellofemoral pain and patellofemoral osteoarthritis are highly prevalent knee disorders associated with pain and functional limitations. The subscale of the Knee Injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF) was developed to evaluate patients with patellofemoral pain and osteoarthritis.

    Measured: Basleine; 6 Weeks

  3. Visual Analogue Scale

    The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain"

    Measured: Baseline; 6 Week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Oct 2026
  2. Study start1 Jun 2026
  3. Primary completion1 Dec 2026 (estimated)
  4. Study completion1 Jan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07854041
Sponsor's protocol ID
Bisma
Status last verified
Sep 2026
First submitted
27 Sep 2026
Last updated
2 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Khammar F, Taghizadeh Delkhoush C, Ehsani F. Study of the electromyographic activity in patellofemoral pain syndrome accompanied by secondary myofascial pain syndrome specifically affecting the popliteus muscle following dry needling: a randomized clinical trial. J Man Manip Ther. 2025 Jun;33(3):195-206. doi: 10.1080/10669817.2024.2396709. Epub 2024 Aug 28.

    PubMed 39196042
  • Kaya D, Callaghan MJ, Ozkan H, Ozdag F, Atay OA, Yuksel I, Doral MN. The effect of an exercise program in conjunction with short-period patellar taping on pain, electromyogram activity, and muscle strength in patellofemoral pain syndrome. Sports Health. 2010 Sep;2(5):410-6. doi: 10.1177/1941738110379214.

    PubMed 23015969
  • Mv VK, Subramanian NB, S S, Kotamraju S, Krishnan M. Physiotherapeutic interventions on quadriceps muscle architecture in patello-femoral pain syndrome. Bioinformation. 2023 Apr 30;19(4):454-459. doi: 10.6026/97320630019454. eCollection 2023.

    PubMed 37822824
  • Callaghan MJ, Selfe J. Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev. 2012 Apr 18;2012(4):CD006717. doi: 10.1002/14651858.CD006717.pub2.

    PubMed 22513943
  • Petersen W, Rembitzki IV, Bruggemann GP, Ellermann A, Best R, Koppenburg AG, Liebau C. Anterior knee pain after total knee arthroplasty: a narrative review. Int Orthop. 2014 Feb;38(2):319-28. doi: 10.1007/s00264-013-2081-4. Epub 2013 Sep 22.

    PubMed 24057656

Questions about this trial

What is this clinical trial studying?

A study testing Group A and Group B in people with Patello Femoral Pain Syndrome, run by Riphah International University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 2 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Syed Shakil ur Rehman, PhD (+92 320 786661, shakil.urrehman@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Lower Extremity Functional Scale (time frame: Baseline; 6 Weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07854041, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in